Effectiveness of a pay-for-performance intervention to improve maternal and child health services in Afghanistan: a cluster-randomized trial
Engineer C, Dale E, Agarwal A, Agarwal A, Alonge O, Edward A, Gupta S, Schuh H, Burnham G, Peters DH (2016) Effectiveness of a pay for performance intervention to improve maternal and child health services in Afghanistan: A cluster-randomized trial, International Journal of Epidemiology, doi: 10.1093/ije/dyv362
A cluster randomized trial of a pay-for-performance (P4P) scheme was implemented in Afghanistan to test whether P4P could improve maternal and child (MCH) services. The authors found that the intervention had minimal effect, possibly due to difficulties communicating with health workers and inattention to demand-side factors. P4P interventions need to consider management and community demand issues.